PREDILATION BALLOONING IN HIGH THROMBUS LADEN ST ELEVATION MYOCARDIAL INFARCTION IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY REVASCULARIZATION.

Abstract

ABSTRACT
BACKGROUND: In some cases, thrombus fragments created during predilation ballooning
may cause distal embolization leading to slow flow or no-reflow. OBJECTIVE: To investigate
the occurrence of intraprocedural slow flow/no reflow following primary percutaneous
coronary intervention in patients with significant thrombus load both with and without
predilation ballooning for culprit lesion preparation. MATERIAL AND METHODS: This
descriptive observational study was carried out at interventional cardiology unit Hayatabad
Medical Complex Peshawar from January 2022 to December 20222. Total 250 patients were
enrolled. Clinical practice recommendations for the management of STEMI were followed
during the entirety of all main PCI operations. The thrombus grade was divided into G0 to G5
categories. High thrombus burden is classified as grade 4, which means that the complete
vascular blockage has thrombus covering more than half of the artery diameter. RESULTS:
Total 250 patients were included in the study. Age ranged between 35-75 years with a mean
age of 55 years. There were 152(60%) male while 98(40%) females with a ratio of 1.6:1.
Patient were divided into 2 group i.e. group A (149, 59.6%) patients & group B (101,40.4%)
patients. Group A consists of patients in whom Predilation ballooning was performed while
Group B patients underwent Dottering and direct stenting. CONCLUSION. In patients with a
significant thrombus burden, predilation ballooning may be linked to an increased risk of
intraprocedural slow flow / no reflow after primary per cutaneous coronary intervention